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Characterization of prognosis indicators in a population of dogs with cutaneous mast cell tumors treated at an oncology referral center in Portugal
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Os mastocitomas cutâneos (cMCTs) são uma das neoplasias cutâneas malignas mais frequentes em cães, correspondendo a 7-21% de todos os tumores cutâneos diagnosticados. A heterogeneidade e comportamento biológico variável destes tumores tornam o prognóstico e plano terapêutico elementos fundamentais na abordagem clínica destes casos. O presente estudo teve como objetivo principal caracterizar uma amostra populacional de cães diagnosticados com cMCT e avaliar a influência de fatores epidemiológicos, clínicos e histológicos no tempo de sobrevivência (ST), de forma a identificar fatores de prognóstico significativos. Um objetivo adicional foi analisar o impacto da vinblastina (VBL) em contexto neoadjuvante na redução da dimensão do tumor, uma vez que 10 animais desta amostra tinham sido submetidos a este tratamento. O estudo retrospetivo foi realizado com base em 65 casos de mastocitoma cutâneo, recolhidos do Centro de Oncologia de Referência do Anicura Atlântico Hospital Veterinário (HVA). Os casos foram caracterizados de acordo com o sexo, idade, estado reprodutivo, raça, presença de comorbilidades, referência, tipo de lesão e localização, método de diagnóstico e tratamento, sendo ainda distribuídos em grau histológico, estadiamento clínico e marcadores de proliferação celular. Na análise de sobrevivência, verificou-se que o grau de estadiamento clínico (p=0.039), a dimensão do tumor (p=0.028), o índice de Ki-67 (p=0.024) e estado reprodutivo (p=0.001) influenciaram significativamente o ST. A cirurgia demonstrou ser curativa na maioria dos casos, com uma taxa de recidiva reduzida. Relativamente ao tratamento com VBL neoadjuvante, observou-se uma redução significativa do tamanho tumoral (p=0.011), sendo comprovado o seu efeito citoredutor, com uma diminuição média de aproximadamente 26% após tratamento com VBL. Na associação entre animais tratados e não tratados com VBL neoadjuvante e o ST, período livre de doença (DFI) e recidiva verificou se que, apesar das diferenças não serem significativas, os animais não sujeitos ao tratamento apresentavam ST e DFI mais longos, assim como menor probabilidade de recidiva. Este estudo retrospetivo permitiu identificar fatores de prognóstico significativos, tal como o estado reprodutivo fértil, descrito pela primeira vez como potencial fator protetor na sobrevivência, e uma melhor compreensão do papel da vinblastina em contexto neoadjuvante no tratamento do cMCT
Canine cutaneous mast cell tumors (cMCTs) are among the most frequent malignant skin neoplasms in dogs, accounting for 7-21% of all diagnosed cutaneous tumors. The heterogeneity and variable biological behavior of these tumors make prognosis and therapeutic planning crucial elements in their clinical management. The main objective of this study was to characterize a population of dogs diagnosed with cMCT and to evaluate the influence of epidemiological, clinical and histological factors on survival time (ST), in order to identify significant prognostic factors. An additional objective was to investigate the impact of vinblastine (VBL) used in a neoadjuvant approach on tumor size reduction, as 10 animals in the present study had received this treatment. This retrospective study was based on 65 cases of cMCT collected at the Oncology Referral Center of the Anicura Atlântico Veterinary Hospital (HVA). Cases were characterized according to sex, age, reproductive status, breed, presence of comorbidities, referral source, lesion type and location, diagnostic method and treatment. They were further classified by histological grade, clinical stage and cell proliferation markers. Survival analysis showed that clinical stage (p = 0.039), tumor size (p = 0.028), Ki-67 index (p = 0.024) and reproductive status (p = 0.001) significantly influenced ST. Surgery showed to be curative in most cases, with a low recurrence rate. Regarding neoadjuvant VBL treatment, a significant tumor size reduction was observed (p = 0.011), confirming its cytoreductive potential, with an average decrease of approximately 26% following VBL administration. When comparing animals treated and not treated with neoadjuvant VBL in relation to ST, disease-free interval (DFI) and recurrence, although differences were not statistically significant, animals without neoadjuvant VBL treatment showed longer ST and DFI, as well as lower probabilities of recurrence. This retrospective study allowed the identification of significant prognostic factors, in particular reproductive status intact as a possible protective factor on survival and contributed to a better understanding of the role of vinblastine as a neoadjuvant therapy in the treatment of cMCT
Canine cutaneous mast cell tumors (cMCTs) are among the most frequent malignant skin neoplasms in dogs, accounting for 7-21% of all diagnosed cutaneous tumors. The heterogeneity and variable biological behavior of these tumors make prognosis and therapeutic planning crucial elements in their clinical management. The main objective of this study was to characterize a population of dogs diagnosed with cMCT and to evaluate the influence of epidemiological, clinical and histological factors on survival time (ST), in order to identify significant prognostic factors. An additional objective was to investigate the impact of vinblastine (VBL) used in a neoadjuvant approach on tumor size reduction, as 10 animals in the present study had received this treatment. This retrospective study was based on 65 cases of cMCT collected at the Oncology Referral Center of the Anicura Atlântico Veterinary Hospital (HVA). Cases were characterized according to sex, age, reproductive status, breed, presence of comorbidities, referral source, lesion type and location, diagnostic method and treatment. They were further classified by histological grade, clinical stage and cell proliferation markers. Survival analysis showed that clinical stage (p = 0.039), tumor size (p = 0.028), Ki-67 index (p = 0.024) and reproductive status (p = 0.001) significantly influenced ST. Surgery showed to be curative in most cases, with a low recurrence rate. Regarding neoadjuvant VBL treatment, a significant tumor size reduction was observed (p = 0.011), confirming its cytoreductive potential, with an average decrease of approximately 26% following VBL administration. When comparing animals treated and not treated with neoadjuvant VBL in relation to ST, disease-free interval (DFI) and recurrence, although differences were not statistically significant, animals without neoadjuvant VBL treatment showed longer ST and DFI, as well as lower probabilities of recurrence. This retrospective study allowed the identification of significant prognostic factors, in particular reproductive status intact as a possible protective factor on survival and contributed to a better understanding of the role of vinblastine as a neoadjuvant therapy in the treatment of cMCT
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária, área científica de Clínica
Palavras-chave
Mastocitoma Cutâneo Prognóstico Sobrevivência Vinblastina Fertilidade Cutaneous Mast Cell Tumor Prognosis Survival Vinblastine Intact dogs